Thursday, July 28, 2011

The Breast Cancer News Update: July 28

One of the most serious side effects associated with breast cancer surgery is lymphedema. In today's breast cancer news update, we'll discuss a white paper by an expert panel on a plan for early detection and treatment. We'll also
look at the latest news on computer-aided detection in mammography and an alternative to surgical nipple reconstruction. Links to today's news stories may be found on the treatment pages of the website.

The early detection of lymphedema

Lymphedema is a painful arm swelling caused by lymphatic fluid accumulation. It is most commonly associated with axillary lymph node dissection, but can be caused by any treatment which damages the lymphatic system. It is universally recognized that early detection and treatment yields the best results.

Yesterday, an expert panel convened by the Avon Foundation for Women, the Lymphatic Research Foundation and the National Lymphatic Network issued a white paper on lymphedema detection and care. Both the white paper and a PR Newswire press release may be found on the axillary lymph node dissection page of our website.

Typically, lymphedema is not detected until discomfort is present or swelling is visible. The white paper reviews the recent research and recommends pre-treatment baseline measurement and continuous monitoring post-treatment to detect lymphedema before visible swelling and discomfort. This is a novel recommendation. For example, the National Cancer Institute publishes a comprehensive summary of lymphedema (link), but the only preventative measure suggested is notifying your doctor if you notice signs of lymphedema such as discomfort and swelling.

In addition to early detection, the benefits of physical therapy, weight bearing exercise the compression sleeves are also discussed in the paper.

Breast cancer patients facing surgery or radiation may want to print the white paper and/or press release and discuss baseline measurements, post-treatment monitoring, exercise, compression sleeves and other lymphedema prevention techniques with their doctors. With proper monitoring, lymphedema may be detected and treated before obvious symptoms appear.

Computer-aided detection does not improve mammography

There's been some media buzz on a July 27 Journal of the National Cancer Institute study of computer-aided detection CAD) in screening mammography. Yesterday, both the Los Angeles Times and US News and World Report covered the study.

What is CAD? Basically, it's a software that scans a mammographic image to identify abnormalities. As defined by the American College of Radiology, it's a "computer-based process designed to analyze mammographic images for suspicious areas; in effect, it is a "second pair of eyes" for the radiologist." In the U.S., it is used in three out of four breast cancer screenings.

What did the study find? An analysis of 1.6 million screening mammograms revealed that CAD did not improve the detection of invasive breast cancer. It did improve the detection of DCIS, but not with statistical significance. In US News and World Report, study author, Dr. Joshua J. Fenton mentioned a "slightly increased chance" of unnecessary recall if a mammogram was read with CAD. "For every 200 women who are screened with CAD who have a second mammogram, one additional woman is called back unnecessarily for further testing," he said.

Tattoos as an alternative to surgical nipple reconstruction

What are nipple tattoos? The latest fad or fashion statement? No, nipple tattoos may be a realistic option to surgical nipple reconstruction for women who have had breast reconstruction after mastectomy. An interesting Philadelphia Inquirer story discusses the procedure and interviews a tattoo artist and her patients.

Please check back tomorrow for more news updates from

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